Surgical treatment of complicated lumbar spinal stenosis
- VernacularTitle:复杂性腰椎管狭窄症的外科治疗
- Author:
Dingjun HAO
;
Baorong HE
;
Hua GUO
- Publication Type:Journal Article
- Keywords:
lumbar spinal stenosis;
spondylolishesis;
scoliosis;
operation
- From:
Orthopedic Journal of China
2006;0(15):-
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To investigate the methods of surgical treatment of complicated lumbar spinal stenosis. [Methods]Totally 176 patients who were diagnosed as having complicated lumbar spinal stenosis,operated by back decompression,fused by bone graft and internal fixed by pedicle screws from January 1997 to January 2001 were retrospectively analyzed.Ninety-eight were males and 78 were females,with an average age of 58.5 years.Patient history was from 2 to 31 years.Thirty-five patients had a previous surgery on lumbar vertebrae,and 19 patients had two or more.Forty patients were complicated with one degree degenerated olisthe,42 were complicated with lumbar scoliosis and Cobb's angle more than 20?,21 had lumbar unsteadiness after surgery,19 patients had spinal stenosis in juncture after surgery.One ore two segments intervertebral discs were removed and vertebral plate were closed together,fused by bone graft and fused articular process.To the patients with more than two segments affection,processus articularis and processus transverses were fused to the patients need not remove intervertebral disk or remove less than half of processus articularis and interbody vertebral were fused to the patient need remove intervertebral disk.Patients with scoliolosis were decompressed and inserted pedicle screws.Revolve rod combined with compression and brace technique was used to correct scoliolosis,fuse the disk and articular process to the patient with severe intervertebral disk hernia and others were fused post-lateraly.[Results]Operation time was from 80 to 250 minutes.Blood loss was from 450ml to 1600ml and no patient died.The follow-up duration averaged 5.6 years.Fused disks had good to excellent rate of 87.4%,and multi-segments had good to excellent rate of 86.1%,and combined with scoliolosis good to excellent rate of 89.8%.The Cobb's angle was average 6.7? and correct rate was 73.8%.The fused rate of post-lateral was 92%(60/65),while the interbody vertebral fused rate was 97.9%(139/142).[Conclusion]The operation of complicated lumbar spinal stenosis is difficult to operate and has high risk.Back decompression,fused by bone graft and internal fixation by pedicle screws is a good method.
